Friday, August 31, 2007

Parke Dieckmeyer's addiction began his freshman year of college. To feed his habit, he found himself skipping classes and staying up all night isolated in his dorm room.

Things got so bad that during finals week, he asked his resident assistant to lock up the source of his addiction so he'd be forced to study. It wasn't alcohol or a crack pipe that had to be hidden away. It was Dieckmeyer's computer.

He was addicted to video games. “I would even have dreams of being in the game,” he said. “It invades your mind.”

Fostering obsessive behavior

Addiction to video games, particularly the online interactive variety, is a growing phenomenon that affects people of all ages and professions.

Though not officially recognized as a medical condition, game addiction has fostered a tidal wave of anecdotal evidence about people who shun families and careers to devote huge chunks of their lives to games. More academic evidence is cropping up, as well as clinical treatment programs.

Dieckmeyer, now a 25-year-old Web developer, would spend six, eight or even more hours per day playing. Starting out with first-person “shooter” games like Counter-Strike, by his senior year he'd moved on to World of Warcraft, an MMORPG — massive multi-player online role-playing game.

In these games, players create characters they control in a virtually limitless world where they team up and interact with other players. Often set against a sword-and-sorcery or science fiction backdrop, MMORPGs have no traditional ending. Players strive for months or years to make their character more powerful and vanquish mighty foes, only to see expansions of the game broaden the horizon ever further.

It's the very open-ended nature of these games that makes them so appealing and, critics say, likely to foster obsessive behavior.

“The game manufacturers, especially in WoW, have built the game to make people put in time,” said Dieckmeyer. “If you're not putting in hours and hours and hours, you're not going to enjoy the game as much as people who do put in the time.”

Dieckmeyer continued playing after graduation, even after getting a job and marrying his high-school girlfriend, Christina. At one point, he realized he was spending a quarter of his waking hours playing World of Warcraft. He tried quitting, but soon resumed.

Christina said her husband's constant gaming was a source of contention. She was annoyed that their socializing had to be scheduled around his gaming. They fought about it occasionally, and she teased him about buying one of the “Warcraft Widow” T-shirts readily available on the Web.

Then Christina found out she was having a baby.

“Once I got pregnant, I joked with him, ‘You've got nine months to play the game, and then it's time to stop.' I guess I pressured him a little bit, but he made the decision mostly on his own,” she said.

“Granted,” she added, “he waited till the very last minute until the baby was here.”

Brynn Dieckmeyer was born five months ago, a few days after her dad gave up World of Warcraft. Though he never sought treatment, Dieckmeyer looked at models of alcohol addiction and decided he had a problem.

“I quit the game because I had a child. I could see it impacting my life in a negative way. It would take away from my lifestyle and family,” he said.

The decision to stop playing can be a watershed moment in gamers' lives — evidenced by the hundreds of videos posted on YouTube by people quitting MMORPGs. Often set to hauntingly beautiful music as players delete their characters, they are digital diaries filled with lamentation for the time spent in-game, as well as boastfulness about their virtual accomplishments.

Dieckmeyer says he'll avoid MMORPGs from now on. He still plays video games but limits himself to console gaming like Xbox 360 and Nintendo Wii, where the games tend to be more action-oriented and have definitive conclusions.

He admits the temptation is still there, especially when he talks with friends, most of whom still play World of Warcraft. It's not unlike, he said, an alcoholic on the wagon hanging out with his drinking buddies, nursing a ginger ale while eyeing their gin-and-tonics.

Almost like alcohol addiction

Liz Woolley believes the alcohol comparison is appropriate. Active in Alcoholics Anonymous as a recovering alcoholic, she built her Web forum for gaming addicts, On-Line Gamers Anonymous, using the same basic tenants and 12-step recovery program as AA.

Woolley, of Harrisburg, Pa., squarely places the blame for game addiction on the companies that manufacture MMORPGs. Because most of these games require a monthly subscription fee — generally about $15 — on top of the purchase price, they can be hugely profitable.

“Those new games, they're virtual worlds. They were created by the gaming companies to be addictive. They have staffs of people with degrees in psychology to make them as addicting as possible,” Woolley says. “People do get hooked in, and they get their mind taken over.”

Woolley says her son, Shawn, started playing Everquest, an early breakout MMORPG, at age 20 and soon became withdrawn, sullen and resentful of any urging to quit. Within three months of buying the game, Shawn had lost his job and been evicted from his apartment.

In November 2001, Shawn fatally shot himself while sitting at his computer. Liz found him dead on Thanksgiving Day. The game was still running. “That was his little message,” Woolley says.

She said Shawn had been playing regular video games for a decade and never had a problem with them like he did with MMORPGs.

Coleen Moore, coordinator of resource development at the Illinois Institute for Addiction Recovery in Peoria, Ill., says the interactive nature of these games is a huge draw, to the point that gamers eschew real-life relationships for virtual ones. MMORPGs allow someone struggling to establish a career or interpersonal relationships to take on the role of a dwarf warrior or undead sorcerer who's revered by other players.

“That's the high that allows them to kind of create their own persona, and be the person they maybe want to be, or the fantasy that they have about what they want in their life,” Moore says.

Bob Appelman, who studies game design at Indiana University, cited a student survey done last fall of heavy Warcraft players. Rather than experiencing isolation, many reported feeling enriched by the esteem they gained from other players.

“They felt empowered, whereas in the real world they were just followers,” Appelman says.

Moore's institute began treating Internet addiction in 1996, and in recent years has seen a spike in gaming problems. The game most cited is World of Warcraft, likely due to its popularity — more than 8.5 million players worldwide.

Officials at Blizzard Entertainment, which manufactures World of Warcraft, did not respond to requests for comment. But the company has highlighted its incorporation of parental controls that allows parents to schedule when and how long children can play.

In June, the American Medical Association rejected a proposal to recognize video game addiction as a psychiatric condition on par with alcohol or drug abuse.

But President Ronald Davis called for more study of the problem, and told the Associated Press that the AMA “remains concerned about the behavioral, health and societal effects of video game and Internet overuse.”

Durwin Talon, an associate professor who teaches video game design at IUPUI, tells his students to seek a balance where people really want to play their games, but without an obsessive need to do it all the time.

“The philosophy ... is that you should have a ‘back door' for people who play your games to hit ‘Save' and have their lives back,” Talon says. “You never want them to get into a situation where they're constantly playing these games, and they don't feel like they can leave.”

Thursday, August 30, 2007

Amy LeJune didn't feel tipsy when she blew into a personal breathalyzer.

But in just a few seconds, the sleek, cellphone-size device beeped and displayed her blood-alcohol level, which was 0.06 -- perilously close to Texas' 0.08 limit, which would mean certain arrest if she were stopped by police while driving home.

"I don't feel like I'm drunk at all," said the Grand Prairie woman, who on a recent evening took the breath test in the stairwell of downtown Fort Worth's Pour House, where she had consumed three beers. "I would think I could drive right now. I wouldn't have any hesitation getting in the car, which is kind of scary."

Alcohol breath-test machines, the tools of police and probation officers, are becoming a hit with social drinkers. Consumer versions of the same technology used by officers for decades to measure blood-alcohol concentration are now small enough to fit into a pocket or purse. The price has dropped because high-tech improvements since 2004 have made them cheaper to manufacture.

But critics warn that making it easier for people to check their own sobriety doesn't necessarily make the streets safer. "It gives people a false sense of security," said Misty Moyse, spokeswoman for Mothers Against Drunk Driving's national headquarters in Irving. "Alcohol affects people differently, and impairment begins with the first drink."

And just because the gadgets are now easy to carry around doesn't mean they're easy to use. A Star-Telegram test of one model showed that the instrument, while technically accurate, was tricky to operate and sometimes gave misleading results.

"I think if they can afford it, and they will use it correctly, it will be a very valuable tool," said Steven Kleypas, who oversees the breath-alcohol training program at the Tarrant County College Northwest Campus. "The problem is, they tend to use it as a play toy, and it's very easy to damage one."

DWI crackdown

This week across North Texas and the U.S., officers are conducting drunken-driving sweeps. The Labor Day weekend is typically a time when extra officers are on patrol, searching for drivers who are swerving, speeding or otherwise behaving dangerously.

In many of those cities, police oppose the personal breath-test gadgets. They suspect that many drivers wouldn't know how to interpret the results.

"It's easy to fool yourself. You could be impaired even if you're not over or at the legal limit," said Christy Gilfour, Arlington police spokeswoman. "If 0.08 is the legal limit, does that mean 0.07 is OK to drive? It's good for people to be educated about the effects of alcohol, but it would not be wise for them to try to educate themselves while in an inebriated state."

Knowing your limits

Advocates of the gadgets say people ought to be able to test themselves before they get into trouble. They note that plenty of agencies use essentially the same technology to test suspected alcohol abusers after the fact:

Drunken-driving offenders in Texas and elsewhere often must install interlocking devices on their ignition, requiring them to blow into a machine before their car will start.

Some shelters require the homeless to blow into a device before entry.

Employers use the instruments to test workers in safety-sensitive jobs -- a forklift driver, for example.

While police typically can't use the results of handheld machines in court, they can use the devices to get probable cause of intoxication and make an arrest -- then take the suspect for a more formal, court-enforceable test later at the police station.

Despite MADD's official position against the personal machines, at least one MADD chapter in Arizona uses such a device to monitor drunken-driving offenders attending a court-mandated meeting with victims. One of the requirements of the sessions is that the offenders should not show up with booze on their breath.

Restaurateurs and others who serve drinks say the breath testers could ultimately reduce alcohol-related fatalities. Giving people as much information as possible about the effects of alcohol logically would make for a more educated and responsible society, said Sarah Longwell, spokeswoman for the Washington-based American Beverage Institute. The institute represents restaurants and other businesses that serve drinks, and it generally believes that moderate drinkers aren't a safety threat behind the wheel.

"It allows people to clearly understand the law, and the distinction between responsible drinking and driving, and drunk driving," she said. "What's wrong with people understanding what 0.08 means? Right now, a 120-pound woman who has two glasses of wine can be 0.08, and she's punished at the same level as a big guy who's had 15 beers and is driving with a BAC of 0.15."

Availability

Many are sold online, while others can be found in catalogs or electronic stores. At Sharper Image in Hurst's North East Mall, two to three people a week stop in looking for a breath-test machine, manager Ferdinand George said. "For some reason, the customers really like them black," he said. "If it's black, you can keep it inside the purse, and you really can't see it."

Stamp of approval

A breath-test machine is considered a medical-testing device and is regulated by the Food and Drug Administration, which has put its seal of approval on 10 models, an agency spokeswoman said.

Design standards for personal breath-testing devices are set by the U.S. Transportation Department, although that agency doesn't endorse them for consumer use. The standards were originally created for breath-test models used by law enforcement and employment screeners.

Some consumer models mention in their advertisements that they comply with Transportation Department standards. They are sometimes tested in private labs that mimic the department's testing standards, so they can include the claim in their advertising.

What is it?

A personal breathalyzer is a battery-operated device that calculates how much alcohol is in a person's bloodstream by analyzing air from deep inside the lungs.

How does it work?

The user typically must refrain from eating, drinking or smoking for 15 to 20 minutes, to avoid getting a false reading or damaging the instrument's sensors. The user turns on the machine, takes a deep breath and exhales for about five seconds into a small sensor. A digital reading usually appears within seconds.

How much does it cost?

Several models can be bought for $80 to $140.

What they're saying

"We know these units are saving lives, just from talking with customers over the years. You can't argue with a number."

Keith Nothacker, founder of KHN Solutions, maker of the BACtrack.

"This is awesome. If you're driving, sure, it could be a good deterrent."

Jeff Harrison, above, of Fort Worth, whose rate was 0.12. He said he lived a block away and intended to walk home.

"I think it's wrong. If you've had as much beer as I've had, there's no way I can drive."

Kevin Timmons of Grapevine registered a 0.06. He said he was going to take a cab home.

"It gives people a false sense of security. Alcohol affects people differently, and impairment begins with the first drink."

Misty Moyse, spokeswoman for Mothers Against Drunk Driving's national headquarters in Irving

Crackdown

This week a national impaired-driving crackdown gets into high gear.

More than $1 million is being spent on increased DWI enforcement in Texas. The Texas Department of Transportation is posting messages such as "Drink, drive, go to jail" on its electronic highway signs.

Officials have stepped up Labor Day weekend drunken-driving police patrols.

The toll

There were 1,354 alcohol-related deaths in Texas last year, the highest of any state, U.S. Transportation Department records show.

Nationwide, 13,470 people were killed last year in crashes involving a driver or a motorcycle rider with a blood-alcohol level of 0.08 or higher.

Tuesday, August 28, 2007

Living in neighborhoods characterized by unemployment, poverty, poor family integration and high residential mobility is known to contribute to a greater risk for alcohol problems. New research, the first of its kind, has found that the reverse relationship is also true: alcoholism has a negative effect on where someone lives.

"Most studies have looked at the effects of neighborhood characteristics on alcohol use, and only a few have looked at alcohol dependence," said Anne Buu, research investigator of psychiatry at the University of Michigan and corresponding author. "None have looked at these effects over a time span as long as 12 years; most cover only a one- or two-year time span. In addition, we looked at these relationships bidirectionally, that is, the effects of alcohol dependence on place of residence, and the long-term effects of neighborhood on alcohol dependence."

"This type of research is quite innovative and reflects a growing interest in 'macro-level' influences on alcohol-related outcomes," said Ryan Trim, research psychologist at the VA San Diego Healthcare System. "Unlike the extensive research on individual- and family-level risk factors, studies examining the link between alcohol use and neighborhoods have only gained momentum in recent years. Since a large proportion of the risk for alcoholism is environmental -- approximately 40 percent -- it will be increasingly important for researchers and clinicians to have a better understanding of neighborhood-level influences on alcohol use."

Researchers recruited 206 Caucasian men, with an average age of 33 years, through community and district court recruitment from a four-county-wide region. Alcohol-dependence diagnoses were established through semi-structured diagnostic interviews. Residential addresses were noted at baseline, and then at three-year intervals for a 12-year period. Census-tract variables were used to identify neighborhood characteristics.

Analysis indicates that alcoholism has long-term negative effects on place of residence, and vice versa. First, the more alcohol problems a man has, the more likely he is going to remain in -- or migrate into -- a disadvantaged neighborhood. Second, recovery from alcoholism is both protective against a downward social drift and favorable to improved social conditions. In addition, living in worse neighborhoods appears to have an adverse effect on alcoholic symptomatology over time.

In short, said Buu, the causal relationship between alcoholism and neighborhood social environment is a two-way instead of a one-way street. "Continuous alcohol involvement has long-term negative effects on place of residence," she said. "In contrast, recovery from alcoholism is protective against downward social drift."

Both Buu and Trim said that these findings have implications for women, even though they were not among the target study population.

"The effects may be even stronger on women because alcoholic women have a high tendency to marry alcoholic men, referred to as 'assortative mating,' said Buu. "Alcoholic involvement of both partners could speed up the downward social drift."

Buu noted that the study's findings show that the damaging effects of alcoholism are much broader than simple health consequences. "The effects also have a long-term impact on quality of life, including where one lives and their quality of life. Social environment appears to play some role in keeping the disorder going, and possibly even making it worse: we can see effects going from community to individual, and from individual to social environment. Preventive efforts therefore may also have effects in both directions."

Trim added that the results have both cautionary and optimistic applications for alcohol misuse. "The findings highlight the far-reaching impact of alcohol problems on the type of neighborhood an individual could reside in as an adult. Thus, high-risk adults who drift into lower-SES neighborhoods will likely face even greater challenges at recovery due to lack of resources and increased environmental stressors. However, adults who successfully treat their alcohol problems early in life are no more likely to experience this downward social drift than non-alcoholics. I would hope these findings provide additional incentive to any individuals who are unsure or unwilling to enter treatment for alcohol-related problems."

Results are published in the September issue of Alcoholism: Clinical & Experimental Research.

Sunday, August 26, 2007

Presented by The Los Angeles County Sober Living Coalition The Sober Living Network

Saturday October 13, 2007

Hosted byThe Loyola Marymount University Addiction Counseling Program

The program is a day devoted to topics concerning recovery from alcoholism and drug addiction, presented from many viewpoints, and focused on the experiences of people working in the field. Presenters and panelists include psychologists, treatment professionals, sober living providers, physicians, educators and representatives of the criminal justice field.

The idea for this conference originated in discussions about the intersection of sober living with other elements in the continuum of recovery from addiction. The conclusion was that much could be gained from a forum where participants from different fields could meet to discuss common issues, share experiences and seek solutions.

The "Summit" part of the title is the day's theme –a meeting of informed minds from diverse backgrounds to discuss matters of mutual concern. The program will present experience from a variety of disciplines, with the common theme of improving our collective understanding of addiction and recovery.

About the Coalition and Network

Members of the Los Angeles County Sober Living Coalition operate more than 230 independent sober living homes across Los Angeles County. The Coalition is a 501(c)(3) nonprofit organization.

The Sober Living Network is a 501(c)(3) nonprofit organization dedicated to excellence in the operation and management of sober living. Today over 370 Network affiliated homes serve over 12,000 recovering addicts and alcoholics in Southern California each year.

About our Host

The LMU Addiction Counseling Program offers a certification program and continuing education support for counselors working in the field of addiction and recovery. The program features a world class faculty and an innovative curriculum.

Patricia is a 30 year old woman who started using methamphetamine in her last year in college. She found that it gave her "an edge" in studying and on tests. The problem was that she soon found that if she did not have any "meth", she couldn't function at all. She tried many times to shake the habit, and even went through "rehab" three times.

However, after a while no matter what she tried, the depression and lethargy was too much to take and she would relapse. At her lowest point, Patricia weighed 80 pounds, was unemployed, and her health was failing. She finally moved in with her parents and sought help and support.

This story describes the lives of many addicted persons in our society. They are not "Bowery Bums." They are middle and upper class folks, who suffer from a deadly condition that is resistant to treatment. In fact, about 15% of the population suffers from some type of substance dependency or abuse (not counting smoking).

The typical detox/rehab system that John experienced has a success rate of less than 15%. Yet the response to failure is to put people through the same process again and again. Repeating something over and over, and expecting a different outcome has been described as a form of insanity.

What's wrong with the Detox/Rehab Cycle?

The current predominant system of treatment stresses the social aspects of this all-encompassing problem. The usual treatment is to "go to "rehab". While this is differs from place to place and program to program, what usually happens is that after medical "detox", the affected person is sent to a residential program of varying length and luxury or is sent home to a relatively brief outpatient program. After this, the person is released to their previous life and lifestyle to be supported by local 12 step programs, like Alcoholics or Narcotics Anonymous (AA and NA).

This assumes that once an addicted person gets through the first few weeks off their drug they eventually return to normal. This is a fallacy. The withdrawal symptoms, such as depression, anxiety, fatigue, and muscle aches, and can go on and on, sometimes indefinitely. (This is a HUGE problem with methamphetamine use). This condition is called the Post Acute Withdrawal Syndrome (PAW). In addition, there are psychologic triggers for cravings that can themselves cause the return of these physical symptoms. Eventually, almost all of these people succumb and restart using. Here's why...

Top 7 Reasons Why the Detox-Rehab Cycle Doesn't Work

1. It fails to recognize and treat the brain disease that causes drug cravings using amazing new medical advances, including the Prometa protocol and buprenorphine (Suboxone)

2. Most detox-rehab programs don't diagnose and treat underlying psychiatric conditions such as depression, anxiety, and even bipolar disorder. The usual medications used to treat these problems may not help addicts and may actually make the problem much worse.

3. It fails to analyze each person's individual situation and to work with him or her to realize the extent of his or her problem. Addiction counselors should use tools like the Readiness to Change Quadrant Evaluation and then follow up with advanced counseling techniques such as motivational interviewing.

4. Most detox-rehab programs do not effectively evaluate and treat the nutritional aspects of substance abuse using a variety of supplements that vary from person to person.

5. The current detox-rehab cycle does not include treating alcohol and drug addictions on an ongoing and personal basis for at least a year using the Recovery Maintenance Model.

6. Current detox-rehab programs allow addicted persons to return back to their homes and lifestyles after the acute treatment is completed without modifying their environment.

7. The treatment is for "Substance Abuse" and everyone gets basically the same treatment regimen. The person must admit that they are an addict and submit to the program's mandates, even if they do not buy into the process. Many folks do what Patricia in the story did. She "shined it on" until she could get out. Others check out early and return to using very quickly.

Abstinence based programs that keep patients in residence for a specific period and then have them go back to their prior lifestyles are doomed to fail.

In his book, A New Prescription for Addiction, Dr. Richard Gracer outlines a better way to treat and attack the difficult and chronic problems of drug and alcohol addiction. Now you can discover new revolutionary treatments for drug and alcohol addictions many doctors don't know about yet. Get Gracer's new book, "A New Prescription for Addiction" at: http://www.anewprescriptionforaddiction.com and stop spinning your life out of control!

The synthetic drug was modeled after a cytosine compound from the European Labumum tree, combined with an alkaloid from the poppy plant.

Since an estimated 85 per cent of alcoholics are also cigarette smokers, varenicline could have an immediate effect on this common dual addiction. The drug has already been approved by the Food and Drug Administration (FDA) for human use, so Pfizer is likely to be granted a speedy approval for the new indication, sources say. The drug is likely to join Antabuse (disulfiram), Revia (naltrexone), and Campral (acamprosate) as FDA-approved treatments for alcoholism.Selena Bartlett of the UCSF-affiliated Gallo Clinic and Research Center, a co-author of the study, said that the drug works by disrupting the neuronal “reward pathway” of the brain. Specifically, the drug binds to acetylcholine receptors, a neurotransmitter involved in arousal and attention. Through a cascade effect, stimulating these receptors causes a release of dopamine, one of the primary pleasure chemicals in the brain. Varenicline prevents alcohol and nicotine from causing a release of dopamine at those sites.

“Treatments for alcoholism today are like those for schizophrenia in the ‘60s,” Bartlett said. “People don’t talk about it. There are very few treatments, and most drug companies are not interested in it.”

Bartlett said she hoped the research would spur additional studies of drugs for alcoholism. "It’s a disease. If you’ve inherited a gene variant, of if some other cause leads you to alcohol dependence, it should be treated like any disease."

Monday, August 20, 2007

To understand the scope of the problem of teen drinking and alcohol abuse in our area, one needs only talk to a teen that has experienced it.

"(I started drinking) at about 15," said a 17-year-old senior at Northwest High School. "I first started drinking just to get away from the pressure, and it was a way I could relax ... (alcohol) is easy to get a hold of here and it's pretty relaxing, and I have fun."

The teen, who spoke to The Leaf-Chronicle under conditions of anonymity, said there are a lot of teens who drink, and not just from his school.

"There's definitely a lot who drink, for sure," he said.

The teen, who says he drinks about once a week, says he tries to keep his school life and partying separate, but "I have come to school messed up before," and at last year's prom he was "a little tipsy."

The best time he has ever had drinking, the teen said, was followed by the worst hangover he ever had.

"(My friend's) mom got us alcohol and dropped us off (at my house)," the teen said, mentioning he had $60 worth of alcohol plus unknown prescription medicine to party with.

"It was awesome — we drank some on the way to my house, and then when we got back there we took the pills, and after like 20 minutes we were messed up ... the room started spinning ... before we knew it the sun was coming up ... we drank and puked then ate, drank and puked some more.

"I remember waking up and immediately puking in a nearby trash can beside my bed," the teen said. "I was sick for the rest of the day. ... Besides that, I've never had another hangover."

The teen said drinking binges, for him, also led to sexual promiscuity and three instances of drunken driving.

As far as quitting goes, the teen said no amount of education will make him quit — nor will getting caught.

"Right now, I don't think I'll get caught," the teen said. "If I want to quit, I will." A common problem

Vonda St. Amant, development director of the YMCA said stories such as this teen's are not uncommon.

"As we talk with youth who are part of YMCA programs and ask them what are pressing issues that they face and pressures they deal with in school ... what we are hearing most often is the pressure to drink," said St. Amant, noting that while some kids may feel pressured to drink, others simply do it because "it's fun and it provides a spontaneous outcome."

"We knew that in trying to grasp the issue, that underage drinking also leads to other risky behavior," St. Amant said. "It leads to violence, it leads to fighting and it leads to premarital sex."

St. Amant surveyed a group of teens last year about teen drinking and said with most of the responses, "the reason they do it is stress to do well in school and excel in sports and to meet people." A startling call

One local parent knows all too well how prevalent teen drinking is in the area — her son was recently cited by the Montgomery County Sheriff's Office for underage drinking.

It all started with a 3 a.m. phone call.

"He needed a ride to be picked up from his friend's house, and I asked him why," said the mother, who spoke under the condition of anonymity. "He said some kids were drinking and the party got loud, and somebody called the deputies, and they came out and started busting kids. ... They wouldn't let him leave in his car.

"It made me think it is a little more serious than I thought and made me want to find out where this is coming from," she said.

Her son, an 18-year-old who graduated from Montgomery County High School last May, said he started drinking at 17 because "it's a great way to meet people and be social."

The teen's mother took immediate action, grounding him.

"I put him on restriction," she said. "I took away his car and only let him use it for work."

The woman said her son is a good student and had not been rebellious in the past, but her frustration is that "all you can do as a parent is teach your kids what's right and hope your kids make the right decisions.

"It's pretty hard (to stop them from drinking) unless you ostracize them from their friends, and you can't really do that," she said.

"As a parent, we just have to instruct (kids) that what they decide can negatively affect the rest of their lives," she said. "You have to help them see the future beyond the next party."

The woman said her son is now headed in the right direction — he's going to college this fall. Troubled 13-year-old

The Rev. Marvin Barner, founder and chairman of The Ripple, counsels many troubled teens through the faith-based organization, and during the school year he said he may deal with nine or 10 teens a week who have problems with drinking.

"You'd really be surprised," Barner said.

And the problem tends to be caused mostly by peer pressure.

"No child is going to wake up and while mom is fixing breakfast ... wonder, 'Hey, I wonder what Jim Beam tastes like,'" Barner said.

Of those he's counseled, the story of one 13-year-old girl sticks out in his mind.

Barner said he worked with a girl who had been kicked out of school for fighting, and she had turned to drinking for one reason — she felt she couldn't live up to her parents' expectations because of her super-student older sister.

"She catches weight from her parents who ask, 'Why can't you be like your older sister?" Barner said. "Her first form of relaxation was weed, but she didn't like it, and because of peer pressure she was introduced to drinking."

Barner said many children fall to alcohol because they're busy living up to the standards of their parents, who think things should still be done like they were when they were kids.

"These are different fears that kids are dealing with these days," Barner said.

The girl, whom Barner said has been clean for about four months, is now pregnant. A religious view

The Rev. Michael Bane, director of family ministry at Grace Community Church, said he knows from conversations he's had with kids at church that teen drinking is common.

"I do think there's a lot of underage drinking that happens," Bane said. "Is it any more than any other community? I'm not sure, but we do know it's an issue."

Bane said it's not just the bad kids who struggle with drinking — good kids deal with it as well.

"Teens in this generation are curious — they see the commercials and how (drinking) is portrayed," Bane said.

"We try to kind of help them see there are other people out there and that not everybody is drinking," Bane said. 'Cultural piece'

Gavic Chandler, coordinator of Preferred Options child services of Centerstone in Clarksville, said it's obvious there are problems with teen drinking in the area.

"We've had children recently who have gotten into automobile accidents and lost schoolmates to accidents," Chandler said. "There's also kids who have been arrested for other charges and one of the catalysts was consumption of alcohol, access (to things they shouldn't have access to) and boredom."

Chandler also said blanket statements shouldn't be made for all teen drinkers — there are "cultural pieces" involved sometimes.

"It may be a religious piece in which children join at the meal and either wine is served or beer is served and watered down for them until they reach a particular age," Chandler said. "We don't want to make blanket statements because it also has to be made within the context of family dynamics — the family values, the culture and the religion of the family.

"What's not acceptable is inappropriate behavior that draws attention to the experimentation (with alcohol) or use, abuse or addiction," Chandler said.

Friday, August 17, 2007

Immigration - A study finds the pressures of adapting to a new country and culture can often lead to substance abuse.

Adapting to the United States might come with its own side effects. As Spanish speakers learn English, they also turn to illegal drug use, with English-speaking Latinos reporting illegal drug use at a rate 13 times higher than their Spanish-speaking peers, reports an Oregon State University sociologist who studied Washington residents.

The pressures of immigrating can fuel an existing addiction or spark new substance abuse, Portland-area drug and alcohol treatment experts agree. Immigrants face learning a language, finding a home and working two or more jobs, and they often grapple with loneliness.

"That's exactly what we see," says Chris Farentinos, director of ChangePoint, a Portland-based drug and alcohol treatment center where 20 percent of clients speak Spanish. "When they arrive, there's a period of time where they're very poor. As their language skills increase, their disposable income is also increasing, and they have more access to drugs and alcohol."

Other sociologists have studied the effects of acculturation on drug and alcohol use, said Scott Akins, an OSU sociologist and lead author of a study that will be published next spring in the Journal of Drug Issues. But those studies have focused on areas, such as California, with large Latino populations.

Akins said he and his three co-authors are the first to look at the Pacific Northwest, where Latino immigrants tend to be more dispersed and isolated from the churches, cultural centers and family that would tie them to their culture.

"Basically, it's a package deal," Akins said. "When immigrants come to us, they oftentimes get greater job security, more economic benefits, certainly a better quality of life. But along with this you also get another type of thing, such as a much more tolerant attitude toward drug use and a more tolerant attitude toward sex."

Akins used data from a 2003 telephone survey of 6,713 adult Washington residents, 1,690 of them Latino but who were not necessarily recent immigrants. Of those, about 700 answered survey questions in Spanish and about 950 answered in English. Akins measured their level of acculturation by which language they spoke. The study showed 6.4 percent of non-Latino whites reported using illegal drugs in the previous month, compared with 7.2 percent of English-speaking Latinos and less than 1 percent of Spanish speakers.

English speakers also reported more binge drinking.

Drug and alcohol abuse cut across cultures and it's not as though people from Latin America are immune to addiction, says Michael Ann Benchoff, program manager for the Family Latino Outreach and Addictions Treatment program, which serves homeless, Spanish-speaking addicts.

Benchoff questioned whether Spanish speakers trusted the survey-takers enough to answer truthfully about their drug and alcohol habits. Addiction carries a stigma in Latino culture, and adults may want to conceal their drug use from a stranger.

"The perspective is, you don't talk about it," Benchoff said. "You don't talk about mental health. They see that as labeling them as crazy or completely morally corrupt."

Akins acknowledged that underreporting by Spanish speakers might skew his research, but "I don't think it would explain away the findings," he said.

Immigrants tend to arrive in the United States healthy, Farentinos said: "You have to be healthy enough to have the guts to do it." Once they've developed an addiction, a deep sense of shame might prevent them from seeking treatment.

ChangePoint's clients come to it through the court system, usually after domestic violence or driving under the influence lands the person in front of a judge. About half the center's clients receive outpatient services three times a week.

Among Latino immigrants, both new and longtime addicts respond to drug and alcohol treatment that allows them to feel as though they are part of a community, Benchoff said, a feeling they tend to lose upon immigration.

Thursday, August 16, 2007

If alcoholics and drug addicts want to kick their habits, they'd better be ready to snuff out their cigarettes.

Indoors and outdoors, smoking will be banned at 1,400 recovery centers throughout the state starting next summer. In place of their butts, patients will be offered free treatment for their nicotine addictions.

The $8 million program offers addicts an "entire recovery plan," said Karen Carpenter-Palumbo, commissioner for the state Office of Alcoholism and Substance Abuse Services.

"We know that 92 percent of those addicted to alcohol or drugs are smokers," said Carpenter-Palumbo, who was in Middletown yesterday to meet with officials from Orange Regional Medical Center and Catskill Regional Medical Center.

"We know it's a trigger to alcohol and drug addiction. And we know smoking kills 25,000 New Yorkers each year."

But some counselors are concerned the smoking bans will stop some addicts from getting treatment.

"It's easier for the state to make this rule than for people to follow it," said Amado Valdes, supervisor at Restorative Management Corp. in Middletown. "I've helped people kick heroin, cocaine and alcohol. Maybe it's too much to ask them to do."

Repeat offenders of the smoke-free edict could be booted from state-certified programs under the new regulation.

"If they continue to smoke, they'll be moved to a different program or discharged," said Carpenter-Palumbo.

Monroe Bussey, program director at Catholic Charities Community Service in Newburgh, says that would be a mistake.

"We wouldn't want to kick anybody out for smoking," he said. "We need to understand that the needs of the client come first."

Bussey's center is among the 70 percent that currently allow smoking on the premises. He favors providing care for nicotine addiction along with treatment for alcoholism and drug dependency — but he wonders how difficult it will be to get patients and counselors to obey the new rule.

"We have a lot of staff that smokes," he said.

"They'll have to get used to the idea they can't smoke on the property. Nicotine is probably the most addictive substance in the world."

Monday, August 13, 2007

From the rough streets of Vancouver's drug districts to the soft lecture hall seats at the University of Toronto, Nanaimo's Jason Devlin is taking an unorthodox path to becoming a doctor.

Today, Devlin is finishing up another summer in the Applied Environmental Research Lab at Malaspina University-College, where he has been working on innovative ways to measure contaminants in water. Six years ago the high school-dropout was living in Vancouver, spending his days with friends, high on heroin, as 'normal' life went on around them.

Devlin has travelled far from that place of his life, and he's not done yet. The recent bachelor of science graduate at Malaspina University-College packed up his desktop computer this week as he prepares for medical school in Ontario.

If there's one thing he learned, though, it's that he didn't get here on his own. Because of the services available for street kids in Vancouver, Devlin, now 23, was able to stay reasonably healthy until he was ready to recover.

He benefitted from the services, but he knows that many of the estimated 150,000 homeless youth across Canada often do not.

"Vancouver is very good to its homeless," he said.

"Without the services everybody would be hooking, robbing and stealing. It's weird because the services made it easier for me to stay in, but they were necessary for me when I wanted out."

With at least four years of medical school ahead of him, Devlin has yet to decide on a specialty, but he will likely return to the streets where he can battle the HIV/AIDS epidemic, or other communicable diseases that plague the country's poorest people.

Few doctors will have a story like Devlin's. His high school in Powell River expelled him at 14 because of his wild and elaborate clothing choice

Bored in his small town, he and friends would take Ritalin or whatever else they could find to get high.

He later became hooked on cocaine and crystal methamphetamine.

After two years of sleeping on the street, Devlin moved into an apartment, where he said things only got worse. He and his friends would pump heroin into themsleves and then simply lie around in their own filth, until it was time to get more. This pattern continued until the junkies set a date to kick their habits for good. When January 2002 came, only Devlin had actually reduced his drug use to the point where he could quit. Leaving his friends behind, he packed up and returned to his parent's home in Powell River.

When he finished the last of his small stash of heroin, Devlin said the pain was nearly unbearable.

To keep his mind off the long-term withdrawal symptoms, he enrolled in adult basic education programs at the Malaspina campus in Powell River. A year later he graduated high school and enrolled in a four-year degree program in Nanaimo. During his four years he won the Undergraduate Summer Research Award from the Natural Sciences and Engineering Research Council three times. He also received the Governor General's Academic Silver Medal for outstanding achievement in a four-year degree program.

Devlin hopes those achievements, combined with his academic knowledge and unique personal experiences, will give him the skills he needs to bring his life full circle: Back to the streets of Vancouver, to help those who need it most.

Sunday, August 12, 2007

Is it possible that heroin junkies and crackheads are actually rational?

I feel that it is time to share a secret. When I left on my vacation just over a week ago, I was fighting a battle with a deep-rooted addiction. I feel able to admit this, since over the course of my holiday I was able to go through cold turkey, conquer the addiction, and face the world clean.

It's decaffeinated coffee for me from now on.

Addiction—even to something as benign as filter coffee—is an unlikely topic for an economist to tackle, because most economic theory is predicated on rational behavior, and addiction seems to be quintessentially irrational.

The logical response appeared in 1988. "A Theory of Rational Addiction" was published by Kevin M. Murphy and Nobel laureate Gary Becker, and has defined economists' approaches to addiction ever since. The theory is easy to state: Addicts choose their poison despite knowing that it is habit-forming and dangerous, and they do so because they expect the highs to outweigh the lows.

Even other economists are skeptical. "They don't know what they're talking about," opined Thomas Schelling when I met him shortly after he, too, was awarded the Nobel Memorial Prize in Economic Sciences. Schelling had spent years trying to kick his tobacco addiction.

Yet perhaps the rational addiction approach is not quite as absurd as it seems. Some habits are rational to acquire. Dating my girlfriend was habit-forming enough to ask her to be my wife. So far, I have no regrets.

It seems absurd to compare the decision to drink coffee or start dating with the decision to smoke cigarettes or inject heroin, but if Becker and Murphy are right, the difference is not of kind but of degree.

Rational addicts should behave in certain ways. They should, for instance, respond not just to current price increases but to expected future price hikes. If heroin is likely to get more expensive, rational addicts should consider trying to quit before that happens. Addicts may even be more sensitive to lasting price shifts than nonaddicts. And since addiction is self-reinforcing, when the rational addict wants to quit, cold turkey is the efficient way to do it.

Economists have found some evidence to support these ideas: Pamela Mobilia finds that betting at racetracks falls in anticipation of increases in bookies' takings; Nilss Olekalns and Peter Bardsley find that coffee addicts show similar foresight; Philip Cook and George Tauchen found that when some U.S. counties raised taxes on alcohol, liver cirrhosis fell more sharply than overall consumption, suggesting that it was the alcoholics who cut back most.

My own addiction was perfectly rational: I am working on a new book, and as deadlines loomed, I drank more and more coffee, even though I was becoming dependent on the caffeine. Manuscript submitted, I went cold turkey on holiday, knowing that the headaches and sluggishness of mind would be both less painful and less important while wandering around the Welsh coast.

That is only caffeine, of course. But even heroin users can addict themselves and then quit as circumstances dictate. Psychiatrist Lee Robins found that almost half of American soldiers used heroin or opium while in Vietnam, but rather fewer were actually addicted, and almost 90 percent of those kicked the habit upon returning to the United States. I have absolutely no desire to try heroin myself, but it seems that both the decision to start and the decision to try to quit were, like my coffee habit, rational responses to circumstances.

I can't help noting that a large number of British cabinet ministers decided to smoke marijuana at college and then quit later. Whisper it softly, but perhaps not only addicts are rational, but politicians, too.

Friday, August 10, 2007

(Washington, DC)—New data from workplace drug tests conducted by Quest Diagnostics indicate an unprecedented reduction in cocaine use among the U.S. workforce. According to "The Quest Diagnostics Drug Testing Index�: Cocaine Use Among America's Workers—A Special 2007 Mid-Year Report," there was a 15.9 percent decline in the number of drug test positives for cocaine among the combined U.S. workforce during the first six months of 2007 compared to 2006 (.58% January - June 2007 v. .69% in CY2006). The combined U.S. workforce is comprised of general workers and federally mandated, safety sensitive workers.

According to the latest data from Quest Diagnostics, cocaine drug-test positives showed double-digit declines in all but one division of the nation, with the highest declines occurring in the New England area (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont). The division with the second-highest declines in cocaine drug test positives was the West South Central division (Arkansas, Louisiana, Oklahoma, and Texas.)

John Walters, Director of National Drug Control Policy, said, "These data are encouraging. Cocaine has destroyed thousands of lives in the U.S. and brought lawlessness and misery to our neighbors. But in recent years, we have had unprecedented cooperation with leaders in Colombia and Mexico. Now is the time to build on this progress."

"Not only did the positivity rate fall to its lowest level since Quest Diagnostics began reporting on cocaine rates a decade ago, but also the decline was truly across the board, falling by double-digits in all but one of nine regions of the country," said Barry Sample, Ph.D., director of Science and Technology for the Employer Solutions division of Quest Diagnostics. "While it is too soon to point to a trend, the significant decline in positivity rates in different workforce categories and across regions may suggest that our nation's workers are choosing not to use cocaine or that they lack access to the drug."

In July, separate findings from Federal intelligence and law enforcement sources noted reports of cocaine shortages in 37 U.S. cities during the first 6 months of 2007. Several of the cities noted by Federal sources are also reporting increases in the price of cocaine - and in some instances a rapid doubling of prices - suggesting that the U.S. market for cocaine may be under strain. These findings are consistent with the Quest Diagnostics data reflecting a decline in cocaine positivity rates among U.S. workers during the first half of 2007.

About the Quest Diagnostics Drug Testing IndexThe Quest Diagnostics Drug Testing Index is published as a public service for government, media and industry, and has been considered a benchmark for national trends since its inception in 1988. It examines positivity rates, which represent the proportion of positive results for a drug to all such drug tests performed, among three major testing populations: federally mandated, safety-sensitive workers; the general workforce; and the combined U.S. workforce. Federally mandated, safety-sensitive workers include pilots, bus and truck drivers, and workers in nuclear power plants, for whom routine drug testing is mandated by the U.S. Department of Transportation and the Nuclear Regulatory Commission. The Drug Testing Index is released as a full-year and mid-year report. "The Quest Diagnostics Drug Testing Index: Cocaine Use Among America's Workers—A Special 2007 Mid-Year Report" describes positivity rates for cocaine only and does not assess positivity rates for other drugs among U.S. workers.

About Quest DiagnosticsQuest Diagnostics is the leading provider of diagnostic testing, information and services that patients and doctors need to make better healthcare decisions. The company offers the broadest access to diagnostic testing services through its national network of laboratories and patient service centers, and provides interpretive consultation through its extensive medical and scientific staff. Quest Diagnostics is a pioneer in developing innovative new diagnostic tests and advanced healthcare information technology solutions that help improve patient care. Additional company information is available at: www.questdiagnostics.com.

Thursday, August 9, 2007

In the shadow of a freeway overpass on East Lancaster Avenue, Leo Kobinski said banning alcohol near homeless shelters won't work.

To illustrate, he pulled out a ticket he got in mid-July for public intoxication. Like a lot of people who live in or near the homeless shelters, he can't afford to pay the fine, so another ticket is of little consequence.

'I've got 2,000-something dollars' worth of tickets,' he said.

The City Council will vote today on banning alcohol and open containers within 1,000 feet of homeless shelters. It's aimed at curbing public drinking near the shelters on East Lancaster Avenue, just south of downtown Fort Worth.

Fort Worth is the first city in the state to vote on the ban since the Legislature approved the measure this past session, according to a spokesman for state Sen. Rodney Ellis, the law's sponsor.

Council members, advocates for the homeless and shelter managers say the alcohol prohibition can work only as part of a wide-ranging plan to address homelessness, alcoholism, mental illness and other problems that can be found along Lancaster Avenue.

Fort Worth's three main shelters are clustered along Lancaster, and the number of people seeking shelter -- both short-term and long-term -- is growing.

The city is looking for larger solutions, including more transitional housing, where residents can have access to social services while they try to get on their feet.

At the same time, owners of surrounding businesses are becoming frustrated by what they say is a constant parade of people drinking -- sometimes urinating and panhandling -- in the homeless district.

'We have customers that really don't want to come to this area,' said Glen Lea, manager of Marshall Grain Co. on Lancaster near Riverside Drive. 'They stop at Riverside and people are just staring at them. Either that, or they're just staggering out in the street banging on windows, asking for money.'

Suzette Watkins, who owns a kennel near Lancaster and Riverside, said the city needs to impose consequences on people who flout the law.

Right now, she said, 'They get off scot-free.'

Don Shisler, president of the Union Gospel Mission, said the alcohol ban might help remove temptation from children and from people who are trying to quit drinking.

'It would be helpful if that type of influence weren't available to the people we're working with or ministering to,' he said.

But homeless people often walk for miles, so 1,000 feet won't be much of an impediment to those who want to keep drinking, he said.

Other cities have tried similar bans. Seattle prohibits the sale of several brands of fortified wine and malt liquor in its downtown area. Washington, D.C., restricts the sale of single-serving containers in one ward.

But those rules have had little effect, said Michael Stoops, acting executive director of the National Coalition for the Homeless in Washington.

'Prohibiting the sale of alcohol is not going to attack the root cause of substance abuse among homeless people,' he said. 'Detox and residential treatment programs are the way to go.'

Hicks sees the 1,000-foot limit as part of a larger campaign. She and other community activists have been fighting alcohol sales permits for stores along Lancaster and other areas of southeast Fort Worth.

They recently got the Texas Alcoholic Beverage Commission to deny a license to a convenience store at Riverside and Lancaster, which is halfway between two of the major shelters.

'I'm not trying to make everyone alcohol-free. I'm trying to cut down on how many [stores selling alcohol] there are,' she said.

The manager of a convenience store on Lancaster Avenue, who declined to give his name, said the city isn't addressing the right crowd.

'Most of our customers are not shelter people; they're the neighborhood people,' he said.

Beneath the overpass on Lancaster, Kobinski and a knot of other men acknowledged that alcohol is a serious problem on the street. But most of them have already been ticketed for minor offenses such as trespassing and jaywalking and still haven't been able to quit.

Wednesday, August 8, 2007

Last call at any British pub can be like a contact sport, with a crush of drunken customers suddenly heaving toward the bar in search of one last round.

It's a hallowed British tradition, and doctors say an increasingly dangerous one.

Britain's taste for binge drinking, driven by a pub culture in which a good night out means packing in as many pints as possible before the traditional 11 p.m. closing time, could lead to a liver disease epidemic within two decades unless Britons learn to drink more responsibly, experts warn.

"There's been a frightening increase in alcoholic liver disease in recent years," said Dr. Ian Gilmore, president of the Royal College of Physicians.

Deaths from cirrhosis in Britain increased dramatically over the past two decades, while they fell steadily everywhere else in the Western world, according to government statistics.

In England and Wales, 17.5 deaths of every 100,000 men were due to cirrhosis in 2002, up from 8.3 in 1987. And in Scotland, the increase was even more dramatic: 16.9 cirrhosis deaths per every 100,000 men in 1987 to 45.2 per 100,000 in 2002.By comparison, the overall U.S. cirrhosis rate has fallen from 15 deaths per 100,000 in 1973 to nine per 100,000 in 2004. In the European Union, the rate in the early 1980s was about 20 per 100,000 deaths; by 2004, it had fallen to 13 per 100,000. Neither provided a breakdown between men and women. "Deaths from cirrhosis (in Britain) are increasing out of proportion with anywhere else in the world," said Dr. Rajiv Jalan, a consultant hepatologist at London's University College Hospital. Cheaper, more accessible alcohol are partly to blame. Binge drinking in the European Union is highest in Ireland, Finland, Britain and Denmark, according to an EU survey published in March. The survey also found that almost one in five Europeans between the ages of 15 and 24 drinks more than five alcoholic drinks in one sitting.

Nearly one-third of 15- to 16-year-old British students reported having gone binge drinking at least three times during the last month, according to a 2003 European-wide alcohol survey. The legal drinking age in Britain is 18.

Tuesday, August 7, 2007

Related behaviorsalso increase risk

MIAMI — Drug use and the resulting risky behavior are the biggest factors in the spread of HIV/AIDS in the United States, and Hispanic and black men are more likely to be infected this way than others, an AIDS expert told a national AIDS conference this month.

“Drugs, whether you inject them, inhale them or take them orally, alter your judgment and put you at risk for HIV,” Dr. Rhonda Hagler, medical director of Proceed Inc., an Elizabeth, N.J.-based AIDS clinic, told the 2007 National Conference on Latinos and AIDS.

Contracting AIDS through injected drug use is particularly crucial in the Hispanic and black communities, because Hispanic and black men were nearly three times as likely as non-Hispanic white men and nearly twice as likely as Asians to contract AIDS through shared needles, according to a U.S. Centers for Disease Control and Prevention survey in 2004.

Also, Hispanic teens are using drugs — from cocaine to heroin — at somewhat higher rates than blacks or non-Hispanic whites.

Hispanic and black women, on the other hand, were less likely to contract AIDS through drug use than non-Hispanic white and Asian women.

A first step in dealing with the situation, Hagler said, is to put aside prejudices against drug abusers.

“It’s not a moral issue,” she said. “If you’re addicted, you can’t stop. Nancy Reagan’s ‘Just say no’ doesn’t work. So much of HIV treatment of drug addicts is controlled by the opinion of the judge or the social workers. We need to seek expert research to get the scientific facts.”

An additional hardship for Hispanics, another speaker said, is that they tend to be tested later for HIV, the virus that causes AIDS.

“My patients with HIV have a higher viral load because they’ve been infected for a long time, and don’t have the resources to see a doctor,” said Dr. Jose Moreno, professor of clinical medicine at the University of Miami School of Medicine, in an interview last week. “Some of them may be illegal, and they’re afraid of being deported.”

In fact, 43 percent of Hispanics were diagnosed with HIV late in their illness — meaning the HIV progressed to AIDS within a year of the HIV diagnosis — compared with 37 percent of non-Hispanic whites, according to a 2006 report by the CDC. Only 45 percent of Hispanics have ever been tested for HIV, compared with 54 percent of non-Hispanic whites, the study said.

People who are drug-dependent and HIV positive face discouraging additional hurdles, Hagler told the conference, including:

• Higher suicide rates.

• Quicker progression from HIV to AIDS.

• Complicated and unexpected interactions between legal drugs and illegal ones. Alcohol intensifies the toxicity of cocaine, she said. Ritonavir, an HIV drug, increases the potency of Ecstasy and heroin.

• Reluctance of some doctors to give medicine for pain when needed for fear of increasing drug dependence. “A drug abuser gets cancer, and the doctor will only give him Tylenol because he doesn’t want to boost the addiction,” Hagler said.

Also at the conference, actress Rosie Perez, an AIDS activist for 20 years, urged unity in the fight.

“We get tired and frustrated from the apathy there is on this subject,” she said. “We must recommit every morning. We’re all brothers and sisters in this fight.”

Monday, August 6, 2007

THEY may consider it a harmless tipple or the basis of a good night out, but millions of Australians face the lifelong hangover of brain damage due to their drinking, health experts warned on Monday.

Alcohol-treatment group Arbias said as many as two million Australians may be at risk of permanent brain damage from heavy drinking, while more than 200,000 were living with the condition undiagnosed.

The group, which is supported by top agencies such as the Australian Drug Foundation and the Mental Health Council of Australia, said that new research demonstrated people had little idea of the dangers of drinking.

It said a survey it commissioned found that most drinkers were unaware at what point their boozing could lead to a permanent hangover, and many wildly under-estimated how many drinks could cause lifelong harm.

Arbias' Sonia Berton said current drinking levels, combined with ignorance of the dangers, could see an entire generation of Australians brain-damaged by alcohol.

'This is a public health crisis that is looming and it is not a question of how much you have to drink to sustain an alcohol-related brain injury, it's a question of how little,' she said.

'Because Australia has moved to becoming a binge drinking culture, something has to be done.'

According to the national statistics office, the average Australian over 15 downs the equivalent of 9.8 litres of pure alcohol a year.

Arbias says six or more drinks per day for men over a period of eight to 10 years, and three or more for women, puts them at risk of alcohol-related brain damage.

Sunday, August 5, 2007

Twice in the past week, I heard antidepressants being called "happy pills." I do not like this. I take antidepressants. I do not take "happy pills."

When you make a wisecrack about my medicine, I hear you saying that you don't take depression - or antidepressants - seriously.

First, let me say that antidepressants don't make you happy. Ecstasy is a happy pill. Maybe even Viagra. Antidepressants are not happy pills. I do not get high off my antidepressants.

I like the way antidepressants are described on www.depression-guide.com: "They are not happy pills; they don't artificially induce a feeling of bliss or unrealistic well-being. No medication can do that, except for alcohol and some illegal drugs, and their effects don't last. Nor do antidepressants insulate you from life, make you not care about important things, or insensitive to pain or loss. Tranquilizers can do that, for a while, but antidepressants can't."

Here is what antidepressants do: "All antidepressant medications work by influencing the activity of neurotransmitters in the brain. ... Antidepressant medications work by slowing the breakdown of neurotransmitters and enhancing the sensitivity of receptors on the receiving neurons."

I know when I make a stink about "happy pill" jokes, people roll their eyes behind my back. They say I'm too sensitive. "Come on, it was just a joke. You need to lighten up. Can't you take a joke?"

Not funny.

One of the biggest obstacles to seeking treatment for depression is stigma - especially for men. Depression is widely viewed as a namby-pamby pseudo-illness. "It's a great way to get time off from work!" "They're not really sick, they're just faking it!"

When you say stuff like that, people stay in the closet. They don't talk about their disease. And talking about your disease with others who suffer from the same disease has proven to be very, very helpful.

My parents, who had cancer, made great friends and found enormous comfort in their cancer support group. There are support groups for people with HIV, cystic fibrosis, eating disorders, diabetes and Down syndrome. Thank God there are a few mental health self-help groups, like Recovery Inc. But most physicians haven't heard of this 70-year-old self-help group, much less know where and when its meetings are held.

Another problem with the "happy pill" joke is that recovering addicts and alcoholics who also suffer from depression and bipolar - and about half of them do - won't, or feel they can't, take them because a "happy pill" will make them high. And then they relapse. Just ask anyone in the treatment industry: Untreated depression and bipolar is probably the No. 1 cause of relapse.

This is why "happy pill" is not funny to us. We are not faking it. We are not taking "happy pills." We are trying to get well. It's no joke.

Friday, August 3, 2007

There's not enough evidence that an Ottawa program that provides free crack pipes to drug users has directly resulted in lower rates of HIV and hepatitis C infection, says the Ottawa councillor who initiated the program's cancellation.

"We need to have very solid evidence before council endorses any kind of program that sends that kind of mixed message," said Coun. Rick Chiarelli in an interview Tuesday, adding that residents have complained that it encourages illegal drug use.

Councillors voted in favour of Chiarelli's motion in July to end the program at the end of the month.

Chiarelli said the program's cancellation came amid requests from advocates for $500,000 to study how effective the program was at reducing the spread of disease, "which means there is no conclusive evidence one way or the other," he said.

He argued the controversy over the program erodes support for the city's overall strategy to fight drug addiction and accompanying social problems.

Program reduces risk: doctor

Meanwhile, advocates of the program said there is plenty of evidence that distributing free crack pipes reduces the risk of disease transmission, even if transmission rates haven't been measured in relation to the program.

"We know that when folks share drug paraphernalia, that's when they are at risk of transmitting those diseases," said Dr. Dona Bowers, a family physician at the Somerset West Community Health Centre at a news conference held by a group of community agencies Tuesday.

The 10 agencies were announcing their intention to continue the program until the end of the year using their own funding.

Bowers said the program reduces the sharing of homemade crack pipes, which can cause cuts or burns.

She also cited a University of Ottawa study by epidemiology professor Lynne Leonard that showed the program resulted in drug users switching from riskier injection drug use to smoking crack.

"We know that among the IV drug users in our community, there are enormous rates of disease," she said, adding that a fifth of IV drug users are infected with HIV and more than 75 per cent are infected with hepatitis C.

Finally, she added, the program helps drug users develop a relationship with the health and social workers who distribute the crack pipes.

In January, the city's chief medical officer of health, Dr. David Salisbury, told reporters that that the city's HIV infection rate fell from 39 cases in a year to 12 after the program was introduced in 2005.

Thursday, August 2, 2007

The titillating gossip recently might be all about the latest Hollywood celebrity to fall off the wagon and get arrested for alleged drunken driving just weeks after completing a stint in rehab.

But for millions of ordinary Americans struggling to free themselves from alcohol addiction, the story of a dissolute starlet inspires not self-satisfied tut-tutting but rather a grimly familiar dread.

Despite decades of research and dozens of potential treatments, alcoholism, America's most common addiction, remains notoriously difficult to overcome.

More than 30 percent of American adults have abused alcohol or suffered from alcoholism at some point in their lives, according to a new study released this month by the National Institute on Alcohol Abuse and Alcoholism, a branch of the National Institutes of Health.

Yet, only a quarter of those afflicted received any treatment. And other studies show that, at best, only a quarter of those who seek treatment manage to abstain from alcohol for a year.

"Alcohol problems are not just something that affects Hollywood stars," said Dr. Robert Swift, a psychiatrist at Brown University who specializes in alcoholism. "We're talking about a chronic, relapsing condition. And we still have a long way to go in treatment. It's like treatment of cancer - some people can be helped, but others just cannot."

There are traditional "12-step" treatments for alcoholism, such as the program pioneered by Alcoholics Anonymous, that rely largely on peer support to encourage abstinence.

There are several behavioral and cognitive therapies employed by psychologists and psychiatrists to help patients avoid the triggers and thought patterns that impel them to drink.

A new generation of drugs is available to help curb an alcoholic's craving to drink.

And there are posh, in-patient rehabilitation centers - the fashionable retreats of choice for infamous celebrities, disgraced politicians and other well-heeled alcohol abusers - that sometimes sound more like spa resorts than rigorous treatment clinics.

But despite all that variety, experts say there is no unambiguous, foolproof treatment for alcoholism that can ensure success.

HARSH REALITY

Researchers are learning that alcoholism, like addiction to narcotics, causes permanent changes to the brain that can, at best, be ameliorated but never permanently undone.

Moreover, scientists have discovered some people are genetically more susceptible to develop alcoholism if they start drinking, just as some people are more likely to develop diabetes if they eat poorly and don't exercise.

"Once you become an alcoholic or a drug addict, you can't go back," Swift said. "It's something that becomes a chronic illness. So, the idea that you go through rehab and you're cured is really kind of a ridiculous idea. You wouldn't expect that with diabetes, so why do people expect it with alcoholism?"

The scientific findings, in turn, have begun to change the popular perception of alcoholism as a mere failure of will on the part of the drinker to stop drinking.

"The first drink may be volitional, but after one becomes addicted, it becomes a compulsion," said Ann Bradley, spokeswoman for the National Institute on Alcohol Abuse and Alcoholism. "Although we're always to be held responsible for our actions and their outcome, it's pretty fair to say that the most addictive drinking is well outside the control of the drinker."

DEFINITION OF SUCCESS

For more than 70 years, since Alcoholics Anonymous was founded in 1935, complete abstinence from alcohol has been regarded as the only antidote to the disease of alcoholism, and even then, alcoholics never regard themselves as "cured," just in a state of ongoing recovery or remission.

Just one drink, the theory went, and an alcoholic was destined to descend into a debilitating spiral of relapse.

But experts say AA is successful for only about one in five alcoholics. And relapses are so characteristic of the disease that no other combination of drugs or therapy offers much better results, if the measurement is total abstinence maintained for at least a year.

So, rather than discourage alcoholics by insisting on a goal many cannot reach, some alcohol addiction experts have begun changing the definition of success.

A 2005 study by the federal government's alcoholism institute determined nearly 36 percent of U.S. adults suffering from alcoholism could be considered to be in "full recovery" after a year, if the definition of recovery was expanded to include not only complete abstainers (18.2 percent) but also "low-risk" drinkers (17.7 percent) who had managed to cut back, but not completely curtail, their alcohol consumption.

"There's a shift in the treatment approach toward being a little more flexible and being respectful of the patient's goals," said Dr. Edward Nunes, a psychiatry professor at Columbia University in New York and an addiction expert.

"There are many patients for whom abstinence is still the best outcome and the one you should shoot for, but it's clear from clinical experience that there are some patients who can move from problem drinking back to a level of moderated drinking that's not problematic anymore."

If that sounds to skeptics like moving the goal posts to make alcoholism treatment statistics look better, Nunes says that's not the intention of clinicians in the field.

"When we're working with an individual patient, we're not worried about making the numbers look better," he said. "To me, it's a question of how best to engage a patient. If a patient doesn't want to deal with (complete abstinence) right off the bat, it may be better to go with them a certain distance in order to build a relationship."